Failure in Medical Practice: Human Error, System Failure, or Case Severity?

Roman, Mihai Dan; Fleacă, Radu; Boicean, Adrian; Mohor, Cosmin Ioan; Morar, Silviu; Dura, Horațiu; Cristian, Adrian Nicolae; Bratu, Dan; Tănăsescu, Ciprian; Teodoru, Adrian; Necula, Radu; Russu, Octav

doi:10.3390/healthcare10122495

Cited by 6 publications

(3 citation statements)

References 29 publications

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“…It is important to note that medical protocols and knowledge evolve over time, and what was considered standard practice at one point may not be considered best practice in the present. As medical professionals, we must stay up-to-date with the current research and guidelines to provide the best possible care for our patients [29].…”

Section: Discussionmentioning

confidence: 99%

Survival Analysis and Failure Modes of Total Hip Arthroplasty Using a Cemented Semi-Retentive Acetabular Cup

Stan,

Roman,

Orban

et al. 2023

JCM

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To reduce the incidence of total hip revisions, there have been continuous efforts to enhance prosthetic materials and designs to optimize implant survival. A primary implant with a constrained acetabular component is often used to minimize the risk of dislocations even though this approach has some drawbacks as reported in the literature. To address these concerns, this study aimed to assess the survivorship and dislocation rate of a semi-retentive cemented acetabular cup when used as a primary implant. The specific cemented cup that we studied was not present in any study that we consulted, so to fill this gap, we conducted a retrospective examination of 527 cemented hip prostheses that utilized the semi-retentive cup between the years 2005 and 2012. We employed Cox multiple regression models for our statistical analysis. The revision due to dislocation occurred in 12.8% of all cases, with a lower incidence of 5% (14 cases) in age groups >70 years than in age groups <70 years (14%—32 cases) (p < 0.001). The survival rates of the semi-retentive cemented acetabular cup were 98.6% (520 cases) at 5 years and 92.2% (487 cases) at 10 years. The survival rates were significantly lower in women than men, with 1.9% (7 cases) toward 0% at 5 years and 8.1% (30 cases) toward 5% (7 cases) at 10 years (p = 0.002). The difference in failure rates between age groups over 70 years (2.3%—10 cases) and age groups under 70 years (11.5%—34 cases) was also statistically significant (p < 0.001). Our study indicates that the semi-constrained design may cause frequent damage to the polyethylene liner due to impingement and wear, which are the primary factors for failure. Also, this implant has a similar risk of revision due to dislocation as reported in studies and may be beneficial as a primary implant in elderly patients with low-demanding lifestyles, muscular insufficiency, and low compliance regarding hip prosthetic behavior, without a major effect on survivorship.

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Section: Discussionmentioning

confidence: 99%

Survival Analysis and Failure Modes of Total Hip Arthroplasty Using a Cemented Semi-Retentive Acetabular Cup

Stan,

Roman,

Orban

et al. 2023

JCM

Self Cite

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“…External to the practitioner, the complexity of the medical system and the patient's condition (both physically and psychologically) creates an environment where failure is commonplace. 56 Traversing this complicated environment becomes more difficult when one is reminded of the high-stakes nature of health care, where failing can have deleterious effects with life-or-death consequences. This creates a difficult paradox where failure is seemingly inevitable, and yet, simultaneously, must be avoided.…”

Section: Failure In Medicinementioning

confidence: 99%

Embracing failure: Nurturing learning and well-being in anesthesiology and perioperative medicine

Higgins,

Vinson,

Petrini

et al. 2024

International Anesthesiology Clinics

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Failure, ubiquitous in life and medical practice, offers myriad opportunities for learning and growth alongside challenges to overall well-being. In this article, we explore the nature of failure, it’s sources and impacts in perioperative medicine, and the specific challenges it brings to trainee well-being. With a deeper understanding of the societal, psychological and cognitive determinants and effects of failure, we propose solutions in order to harness the opportunities inherent in failures to create brave and supportive learning environments conducive to both education and well-being.

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“…According to contemporary viewpoints, human error is a result of both systemic failure and individual behavior [6], and a comprehensive understanding of these errors necessarily require considering how an individual interacts with their surroundings. Safety-focused cars are ones that support user autonomy and give drivers the least amount of room for accidental error on the road.…”

Section: Introductionmentioning

confidence: 99%